David Cullinane (Waterford, Sinn Fein)
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1. To ask the Minister for Health her current policy on the colocation of the Rotunda Hospital; the amount spent to date on colocation planning, including any preliminary stages; and if she will make a statement on the matter. [17627/26]

David Cullinane (Waterford, Sinn Fein)
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My first question is on the Rotunda Hospital. Since the question was tabled, however, a memo was brought to Cabinet and the Minister has decided to abandon the plans to colocate the Rotunda Hospital with Connolly. If I am right that this is her position, she might outline that. Now the key thing has to be what happens with the critical care unit. I welcome that, as part of an enhanced planning application and the critical care unit, the sexual assault unit will also be enhanced. The Minister might take the opportunity to update the House on those two very important projects.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I thank the Deputy. Just to clarify and for accuracy, I did not bring a memo to Government. That is only a technical point. The Deputy is quite right. What we have decided to do is reflect on the judgment and on the needs of women going forward. The needs of women going forward are for critical care capacity for neonates. I am sure the Deputy has been in the unit in the Rotunda Hospital. They do exceptionally good work but it is not in a suitable place for neonatal intensive care. The idea is to go back in with a new application. All of our options were considered in relation to whether to take a judicial review. That would mean going through an extensive legal process, potentially for two years, to go back into the same body. I am not sure that really meets the needs in any event.

What we have decided to do is enhance the application, to go bigger. We need critical care capacity onsite. From the perspective of patient safety, that enables me to say I am satisfied that the patient safety needs of women on that site are being yet better met. Already, of course, the Rotunda is practically beside the Mater and there are very good bluelight channels, as the Mater has said. No woman has died in the Rotunda in 20 years. It is a safe pathway already but it does need enhancement. That is why that critical care capacity for women as well as for neonates will form part of the new application.

That enables us to delineate the Rotunda from the otherwise important colocation policy of having that critical care capacity for women closer, the case being Holles Street and the National Maternity Hospital. It enables us to remove that from the equation of a new planning application. The colocation question cannot be in the minds of anyone because it is delineated from that in that way. We are intending to go back with a bigger application directly to An Coimisiún Pleanála with critical care capacity for women and an enhanced sexual assault treatment unit. I want everybody here, which I know they will do, to make a statement that the Rotunda is for women in the city centre in every possible way. The Ministers, Deputies O'Callaghan and Chambers and myself will be backing that application and I am sure the Deputy will too.

David Cullinane (Waterford, Sinn Fein)
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The colocation plan unfortunately was an anchor around the hospital for far too long so I welcome the fact that anchor has now been removed. It is policy since 2015 but very little money has been spent on it and there was no real timeframe. An Coimisiún Pleanála's decision did mention colocation not as the main reason but certainly as one of the factors it took into account, so removing that obviously helps.

It is possible and necessary that we protect the built environment that is Parnell Street. Nobody, including the master of the hospital, disputes that the architectural heritage of that building is important. However, it is possible to have a planning application that can address some of those concerns but also provide world-class, first-class buildings and capacity for the staff who, as the Minister said, do a wonderful job in the Rotunda Hospital. I am satisfied that this can be achieved. It will require funding and support at every step of the way from Government.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I agree. Of course, the heritage consideration was the dominant one in that third round for the decision-making. It still remains of importance to that area. However, balancing the public interest is something we do all the time. Dublin City Council and the inspector took the view that in the previous application, the public interest was overwhelmingly served by progressing with it. The deciding body in the end decided in the opposite direction. In many ways, what we say here informs the public interest. We are the representatives of the public in what we say in relation to the importance of the care of women. Successfully and correctly delineating the Rotunda from the colocation policy, which is important for other hospitals, is a significant step in that. I do expect the application to be well supported in the broader public interest.

The Deputy is correct that very little money was spent on the colocation of the Rotunda. However, an enormous amount of money has been spent on colocation policy generally in respect of Holles Street. That reflects the hierarchy of need. The need to move Holles Street was much greater because the patient safety need was much greater, the distance being greater between Holles Street and St. Vincent's than between the Rotunda and the Mater. That speaks to the priority placed on it.

David Cullinane (Waterford, Sinn Fein)
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The decision for the Rotunda in relation to colocation has raised issues around other colocation proposals as well. The Minister mentioned Holles Street, which is moving to Elm Park and which is much more advanced. There is a plan for Limerick and for the Coombe. Now questions are being asked about where they stand, particularly the Coombe, which is to move to the site adjacent to the new children's hospital, which is yet to open. Are there timeframes for that? What is the policy of the Government? Is there any fresh thinking on the Coombe given the decision that was made for the Rotunda Hospital? It is really important that certainty is given to all of those hospitals. I refer to one of the lessons we have to learn if the certainty is not there, if the pathway is not there and if there are no timeframes for colocation while these hospitals are trying to expand and provide the services they need to provide in the here and now as well as for five, ten or 20 years' down the road. Being tied to colocation can be problematic when there are no real timeframes or movement. The Minister might be able to give her insight into the Coombe and Limerick as well.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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The Deputy is exactly right. Holles Street and Elm Park is settled. The question on Limerick forms part of what we are trying to do generally in Limerick and I would be happy to update the Deputy but our policy is very much the same in respect of colocation there. The Deputy is right to identify the Coombe, which is quite close to St. James's Hospital, where we are investing significant additional capacity at present. It is something I am now going to reflect on. I do not want to separate that yet but it is important that we do a detailed analysis of the needs of the Coombe, the adjacency of St. James's and what we have learned in relation to that. Back in 2013, 2014 and 2015, there were discussions about the necessity for trilocation and all those different efforts to try to put those pieces together. Of course, we are learning more and more. We are seeing the different pathways now. The Deputy is right to identify that and I cannot answer that today. It needs more reflection. We can do that collectively over time. There is not the same imperative because we are driving ahead with investment in the Coombe as it is.

David Cullinane (Waterford, Sinn Fein)
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It would be a good issue for the Oireachtas health committee to examine in the next number of months, namely the whole colocation strategy.